Healthcare Provider Details

I. General information

NPI: 1942292826
Provider Name (Legal Business Name): PAUL GREGORY RAUSCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W 7TH ST SUITE 1A
FREDERICK MD
21701-4507
US

IV. Provider business mailing address

501 W 7TH ST SUITE 1A
FREDERICK MD
21701-4507
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-8477
  • Fax: 301-662-4293
Mailing address:
  • Phone: 301-662-8477
  • Fax: 301-662-4293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD0014626
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: